The Electrophysiologist Visit

Willamette Valley, Oregon

I’m not getting paid to say this. But those people and facilities at the Cleveland Clinic (CC) are phenomenal.

My beautiful, talented, and ridiculously smart wife Karen and I took the 50 minute drive to the Clinic this morning and had a great talk with the electrophysiologist. What impressed me the most about him was the fact that he wanted to understand the Why of what was happening more than anything. He knew that the solution was a pacemaker. But the circumstances were puzzling to him.

I envision him waking up at 2am this weekend and calling his colleague and friend, my CC cardiologist, and saying, hey, maybe it was THIS that caused the rapid onset of the second degree AV block.

He just cares that much, you know?

It’s refreshing.

I’ve never really had any “symptoms” of heart issues, even though I was diagnosed with non-ischemic cardiomyopathy in 2007. My local cardiologist—remember, I have two…one nearby, and the other at the Clinic. They actually trained together and talk frequently, which is yet another reason why I feel so fortunate to be getting such great care.

What was I saying? Oh, my local cardiologist mapped out my life for me about 10 years ago. He said the following things are in my future, in this order:

1.       I will experience PACs and PVCs. That’s when you feel your heart fluttering a bit. If feels weird, and for me they would last anywhere from a couple days to a month. Then I wouldn’t notice them. They’re harmless, but any time you can sit there and notice your heart beating, it causes a wee bit of anxiety. So, those came first.

2.       Then he said at some point I would go into AFib (Atrial Fibrillation). That’s a total irregular heartbeat where electrical impulses fire abnormally, causing the atria to quiver. This started about 3 years ago. I’ve been in AFib three times, and was successfully cardioverted out of it each time.
When I went into AFib, I felt my heart go out of rhythm. Not completely different from the PACs, but different enough that I know the difference, so I address them with deference. I would also get sweaty, feel like I have heartburn, and just feel yucky all over.

3.       Then, eventually, I’ll need a pacemaker. They could’ve slapped one in in 2007, but they decided to try some drugs that I am very fond of because of the wonderful work they have done for me. Coreg (Carvedilol) has reshaped and retooled my heart. It was a MESS, but now it’s rollin’! Losartan is also my buddy, as it lowered my blood pressure (which wasn’t super high in the first place) which helps reduce the workload of my heart.

4.       I’ll eventually need a mitral valve replacement. Let’s wait another 15 years or so for that menu item, please!

5.       I’ll live at least til my mid-80s, start my own blog, shoot photos for National Geographic, win a gold medal in the senior Olympics as the starting middle hitter, and hike every trail in the Willamette Valley with Karen.

Actually, I added that fifth one; my cardiologist failed to fill in those blanks when I asked him. They don’t know EVERYTHING, you know.

So that’s all mapped out. But what about experiencing actual ‘symptoms’? Until last week, I never had any! I was a walking time bomb in 2007 until Karen, who would not be my wifey until 2013, suggested I get a complete check up by a cardiologist. I had an ASD repair in 1971 when I was 5, had annual checkups until I went to college, then nothing until 2007 (thank you Karen).

That’s when they discovered all these issues in there.

My impression of “chest pain” is one of a shooting pain coursing through my heart. When I described a chest “pressure” to my cardiologist last week during the stress test, here’s what I felt: It was as though my heart was actually a balloon, and somebody was in there inflating it, putting pressure on everything in there—my chest wall, my lungs, even my upper belly and ribs.

When my cardiologist was dictating stuff and talking about it, he used the term 'chest pain.'

LESSON LEARNED! So if YOU are feeling chest “pressure,” it is actually chest “pain.” GO TO THE EMERGENCY DEPARTMENT. Don’t mess around with that stuff. Don’t be a hero. Go check it out.

The consensus for today is that I need a pacemaker, as expected. Should I get one today? Prob. But the EP is comfortable waiting ‘Til Tuesday (Voices Carry). So I’ll be good and wait!

More info this weekend about what the pacemaker looks like and what it does. (I got a cool diagram from the EP.)